Case Management

Mentor moment: Predicting the expected date of discharge

Case Management Weekly, October 31, 2012

One area of concern is whether to inform patients and their families about the expected LOS and expected date of discharge. The challenge concerns determining upon admission how long a patient will remain. 

Strategies to help determine an expected date of discharge for a specific patient include the following:

  • Ask medically stable patients what they expect regarding LOS
  • Ask the admitting physician or hospitalist about expected LOS
  • Identify ways the physician can indicate in written orders intent to discharge, including the conditions under which the physician will discharge the patient
  • Determine the hospital MS-DRG for the patient’s primary admitting condition and add that time to the days of admission
  • For Medicare beneficiaries, determine the hospital’s overall LOS using the hospital’s Medicare statistics
  • Refer to the hospital-based clinical pathways to identify an estimated LOS
  • Because LOS is directly related to medical necessity for continued stay, discuss establishing a method for determining expected date of discharge with the medical staff
  • Identify where in an existing information technology tools in use by the hospital the expected date of discharge can be displayed
  • Link the expected date of discharge to clinical goals in collaboration with the patient and clinical team
  • Consider posting expected dates of discharge on whiteboards in patient rooms to encourage discussions with patients, family members, physicians, and other healthcare providers 
 Editor’s note: This article is adapted from Discharge Planning Guide: Tools for Compliance, Third Edition published by HCPro, Inc.

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